Anterior Cervical Corpectomy and Fusion

About the Operation

Your doctor has recommended surgery on your neck. This surgery is called an anterior (an- TEER-ee-or) cervical (SERV-uh-KOL) corpectomy (cor-PECK-tuh-me) and fusion (FEW-zhun). Displaced bony disk material will be removed from your neck. This displaced material is causing a problem by pressing on nerves. It will be replaced with bone taken from your hip or the fibula bone in your lower leg.

During the operation, an incision (cut) will be made on your neck (see the diagram below). The size of this incision will depend on the extent of your problem. A second incision will be made on the front of your hip or leg (see the diagram). Bone will be removed from your hip or leg and will be placed in your neck. This transfer is called a bone graft. The surgery may take about four hours.

If you have one or two vertebras repaired (a single-level corpectomy), you will probably be sent directly to a general patient unit after surgery. Your hospital stay will be two to three days.

If you have two or more bones removed (a multiple-level corpectomy), you will probably be sent to the intensive care unit (ICU). During surgery a plastic breathing tube will be inserted down your throat, to keep your airway open. This is necessary because of swelling in your neck. You will remain in the ICU while you have a breathing tube. Most patients stay in the ICU one to two days. Then you will be sent to a general patient unit for two to five days.

Incisions are usually closed with stitches and may be secured with Steri-strip tapes, paperlike strips that stick to your skin and help keep the sides of the incision from shifting. The stitches will dissolve completely. The Steri-strips will fall off by themselves, usually within two weeks of surgery.

After the Operation

After the operation, your throat may be sore from the surgery and the breathing tube. You will be given ice chips or clear liquids. After the breathing tube is removed, ice chips are helpful until normal bowel function returns. Usually, you can eat a soft diet by the time you go home. Your hip or leg may feel sore for several weeks following surgery.

You will wear a Dennison brace or Miami-J collar, which was placed on your neck in the operating room, for about six weeks. You will wear the brace or collar from the time of surgery until your doctor removes it. You will receive instructions about wearing your brace.

On your first day after surgery, you will be able to sit in a chair as often as you like. Physical therapy will begin on that day. If you need to stay in the ICU, physical therapy will begin your first day in the general patient unit. A staff member or physical therapist will help you get a cane or walker if needed after surgery.

At Home

Do not return to work until your doctor says you may.

Do not drive while you are wearing your brace or collar — usually for six weeks.

The brace does not allow peripheral, or side, vision while driving. This is a safety concern as well as a legal issue. In addition, your reaction time may be slower because of pain or certain prescribed medicines.

You may ride in a car from the hospital to your home. You should not take other car trips until your doctor says you may.

Walking is good for you, but you should rest as needed. Do not get overtired. Try to limit going up and down stairs to once a day for one to two weeks.

Avoid strenuous exercise or activities like swimming, golfing, or running until you check with your doctor.

Do not bend from the waist to pick up things. This movement strains your back muscles. You should bend your knees and squat.

Do not carry heavy items, such as groceries or laundry. Do not lift anything heavier than a gallon of milk. Do not try to move heavy furniture until your doctor says you may. Do not lift anything over your head.

Keep the incision dry. Take sponge baths. Do not take tub baths until your doctor says you may. Showering is usually allowed seven to 10 days after surgery, if the incision is not red or draining. Before showering, remove the brace and cover the incision with plastic wrap, to keep water from hitting the incision. Be sure to use a rubber mat in the shower, to prevent slipping. Be careful not to move your neck from side to side while the brace is off.

Usually you may sleep in any position that is comfortable.

You may resume sexual activities when you feel comfortable.

Incisions may be numb or tender for a few weeks after surgery. Some redness around the incision is common and usually disappears within one to three weeks. Ask a family member to help you check your incision regularly.

A raised toilet seat will be provided for you. If necessary, other assistive devices will be arranged for you by hospital staff or your primary care physician. When to Call the Doctor

If you notice any of the following signs of infection, call your doctor or nurse immediately:

Increased redness at the incision site

Increased pain at the site

Increased swelling at the site

Puslike drainage from the site

Black tissue around the site

Fever of 101°F (38.3°C) or above for more than 24 hours

Chills

Use common sense in judging what you can and cannot do. If you have any questions or concerns, please feel free to call your doctor or nurse.

For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1.

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